Hemodynamic alterations in the transferred tissue to lower extremities.
A higher incidence of failure has been reported for free flaps transplanted to the lower extremities. However, the physiological background of this phenomenon has not been elucidated. We reviewed the 3-day postoperative hemodynamic data for 103 free flaps, including the in situ venous pressure (N = 103), arterial pressure (N = 53), and surface blood flow (N = 42). The cases were divided into two groups based on the recipient site, i.e., lower extremity (the LE group: N = 29) and the other (non-LE group: N = 74). The venous pressure was significantly higher in the LE group (26.6 +/- 2.2 vs. 14.8 +/- 1.2 mmHg), whereas the arterial pressure immediately after surgery was lower than the non-LE group. The hemodynamic data within the transferred tissues demonstrated significant differences between groups, especially in the early postoperative period. There is a possibility that the high venous pressure may aggravate the poor perfusion in tissues transferred to the lower extremities.
Sakurai
Hiroyuki
H
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo 162-8666, Japan. bighiro@prs.twmu.ac.jp
Yamaki
Takashi
T
Takeuchi
Masaki
M
Soejima
Kazutaka
K
Kono
Taro
T
Nozaki
Motohiro
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D018409:Foot Injuries / Q000503:physiopathology / Q000601:surgery; D005597:Fractures, Open / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D017078:Laser-Doppler Flowmetry; D007871:Leg Ulcer / Q000503:physiopathology / Q000601:surgery; D035002:Lower Extremity / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply / Q000502:physiology*; D013978:Tibial Fractures / Q000503:physiopathology / Q000601:surgery; D014689:Venous Insufficiency / Q000601:surgery*; D014690:Venous Pressure; D055815:Young Adult